Ethics, Law & Communication

Overview

Ethics, Law and Communication comes down to two questions: what you are allowed to do to a patient, and what you say while you do it. There is no math. The ARRT outline names the legal terms and doctrines, so learn each one well enough to spot it in a short imaging-department scenario and pick the right response.

Start with the legal vocabulary. Assault is the threat; battery is unconsented contact, such as taking a portable chest after the patient refused. Negligence is the unintentional tort, and Ehrlich and Coakes lists four conditions for a malpractice claim: a duty of reasonable care, a loss or injury, a defendant responsible for that loss, and negligence behind it, so no loss means no damages. Res ipsa loquitur lets negligence be presumed when the injury speaks for itself; respondeat superior makes the employer answer for the employee. Patient falls generate more suits against radiographers than anything else.

Consent has levels. The blanket form signed at admission covers routine care only; biopsies, sedation, and arteriography need a written informed consent that explains risks, benefits, alternatives, and the right to withdraw. A competent adult signs for themselves, and a parent or guardian for a minor. Implied consent covers emergencies when nobody can be reached.

The ARRT Standards of Ethics is one document in two parts: an aspirational Code and 22 enforceable Rules. Your own ethics violations go to ARRT within 30 days of the occurrence; a known or probable violation by any registrant or candidate must be reported promptly in writing to ARRT (Rule 21); and errors go immediately to your supervisor, whether or not the patient was injured (Rule 22). HIPAA protects all identifiable health information, spoken included, and ARRT Rule 16 makes viewing confidential patient information without proper grounds an ethics matter in itself. Identify every patient with at least two identifiers, and never the room number.